This work is a review of 62 patients with abuse of phenacetin containing drugs and uroepithelial tumours of the renal pelvis, all of them carcinomas. Most of the patients had a pre-existing nephropathy with papillary necrosis as a prominent feature. Renal impairment contributed to the poor prognosis. On the basis of present knowledge of urinary tract carcinogens and phenacetin metabolites, it is assumed that phenacetin is the crucial factor for development of the tumours.